Archives for Medications

General

Buprenorphine: How many patients is too many?

Last week the Department of Health and Human Services published in the Federal Register a notice of rulemaking for medication assisted treatment - MAT - for opioid abuse that would increase the maximum number of patients a practitioner can treat from 100 to 200. The proposed rule would apply specifically to buprenorphine, also known as "bupe"among drug users. The drug is used to wean addicts off prescription and street opioids, such as oxycodone and heroin. Buprenorphine joins methadone and naltrexone as the only three drugs approved by the Food and Drug Administration to treat opioid addiction. The irony of the government's efforts to regulate patient limits for buprenorphine, is that there are no limits on the number of patients a practitioner can treat with the prescription opioids that feed addition. In fact, there is no other prescription medications with patient limits.
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Alcoholism

A recovered alcoholic asks: If I take antidepressants, am I still sober?

I am a recovered alcoholic. I also have bipolar II, which can manifest in depression. I am what they call "dual-diagnosed" - or "twice blessed" as those of us in recovery often quip. I was about 7 years into my recovery when I slid into a deep depression and was diagnosed and put on medications. The decision to take antidepressants and a mood stabilizer posed a huge ethical and medical conundrum for me. I had heard from many fellow recovering alcoholics that WE DON'T TAKE MIND ALTERING MEDICATIONS! Obviously, antidepressants and mood stabilizers are - thank God - mood altering. Desperate - and with the encouragement of doctor friend who understands addiction - I took them. It took several months find the right dosages and for them to kick in but when they did, my life - and sobriety - completely changed. I'm not saying my life got better but my ability to deal with life got much, much better.
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Alcoholism

4 reasons why addicts should not trust doctors

One Last month I went to the emergency room with tightness in my chest and shortness of breath. I answered a bunch of questions about my medical history, told them about my depression and bipolar, the meds I am on and made it clear that I am a recovered alcoholic/addict and that I do not want to be given any medications that might cause me to relapse. The doctor came, looked at my chart, looked at me and asked if I was in pain. I said no, just uncomfortable tightness and shortness of breath. . "Do you have any pain?" the doctor asked. "I'm going to give you some Ativan. It will help you relax," the doctor said. "No you're not," I said. "I'm a recovered alcoholic/addict and I don't take benzos." "Why?" the doctor asked.
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General

How to screw up taking antidepressants

Once a week I refill my pill box. I take two antidepressants and one mood-stabilizer, along with a handful of supplements - fish oil, glucosamine, daily vitamin etc. One-by-one I take each bottle out of a basket, open it, deposit the pills in their daily nook and put the bottle back into the basket. I take my medications without fail and I have done this little routine countless times over the years. Last week I screwed up. Big time. I forgot to put one of my antidepressants in the mix. It took five days and a swan dive into my black hole before I realized this. I probably would have discovered this faux pas sooner if I had been paying attention but I have been under a lot of stress lately and it has been difficult to focus on anything for long.
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Coping with Depression

Why are all the great Christmas classics about depression?

Ever notice that the great holiday classic are about depression? There's George Bailey, the financially strapped father of a posse of rowdy kids in It's a Wonderful Life. Then there's Scrooge and the Grinch. And how about that Santa-denying mother in Miracle on 34th Street? Charlie Brown and his pathetic little tree. Let's not forget The Littlest Angel, a story about a little boy who dies, goes to heaven, can't keep his halo on straight, can't sing on key with the seraphim and misses his dog? Then there is that country western song little boy who want to buy his dying mama a pair of shoes. We have Elvis' Blue Christmas and Do They Know It's Christmas about people starving in Africa.
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anxiety and dreams

How much sleep is enough/too much when you have depression

The first thing my psych-nurse practitioner said on my first visit during my last major depression was this: "First, we need to get you some sleep." What? I expected her to say anti-depressants - at the time a major fear of mine. But sleep? Really? I immediately decided that I liked this woman because her top priority was something natural - sleep. Although she did prescribe a very low dose of Seroquel to help me sleep soundly, I liked her recognition of the body's own ability to heal itself. Plus, I hadn't had a really good night's sleep in a long time. And I really, really like to sleep.
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Coping with Depression

Four reasons to exercise when you have depression

Shortly before my depression snapped me in half, I went to a spin class at the gym. Of all the exercise I have done - and I have done a lot - spin is the most intense aerobic workouts.

An hour of riding a stationary bike -mostly at your maximum heart rate - and my body is toast. However, my brain is on a pink cloud - awash in endorphins.

But on that day, the endorphins did not...
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Dual-Diagnosis

Addiction treatment: Here’s the prescription for relapse

I met yet another addict who is taking benzos prescribed by a doctor who knew this woman is an addict trying to stay clean.

WTH? (I would like to say WTF? but I'm a lady.)

This addict said the doctor who prescribed her Klonopin and Ativan knows she is in recovery. In fact, he's the doctor who treats clients in her intensive outpatient program. (Again, WTH?)

I have two problems with this common scenario:

Doctors who prescribe benzos to patients...
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Bipolar

Chiropractic care for physical and mental health

My insurance company wants to know why I have been to the chiropractor so much recently. The company has asked my chiropractor for an explanation. I've got an explanation: My back hurts. I did not injure it. I was not in a car accident. I'm 56-years old and sometimes it just goes out of whack. But here is the main reason I've been seeing my chiropractor so much. I am a recovered alcoholic and I have bipolar II. You see, I can't and don't want to take muscle relaxers. I might abuse them. I don't want a shot of some steroid because if you take the pain away without correcting the problem, I will go back to my usual exercise routine and very likely hurt myself. Exercise is a critical component of maintaining my mental health. It's not just the endorphins, it's the way I feel - energized, strong, capable. It builds my self-esteem and gives me confidence. It's the camaraderie and fun I have at the gym. It's my tribe.
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Alcoholism

How my depression nearly killed my sobriety

This month I celebrate 17 years of sobriety. Let me say that again. This month I celebrate 17 years of sobriety. I can't believe I just said that because it seems so impossible and sounds so weird coming from my mouth. 17 years. How the heck did that happen? One day at a time. I also followed suggestions, especially from a doctor friend who told me about 12 years ago that I was in a major depression and needed antidepressants.
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